Insurance denied Eplerenone (Inspra generic)

[Guest guest]

I just learned my insurance, Bravo Health, Medicare Advantage plan, refused to cover Eplerenone. In the prior approval request my Doctor wrote, "patient has hyperaldosterone, with painful bi-lateral gynocomastia. Eplerenone treats the condition without the side effects of spirinolactone." Bravo said not sufficient medical indication.Ouch! Again I say, ouch! It has now moved to the next level; the appeal has been sent. Appeal seems senseless to me. Bravo denied the drug, so we appeal to Bravo? Well duh?! What would we expect from Bravo about Bravo's decision?!So, I ask the group, has anyone else had experience like this? I will keep the group posted on the progress. Krebs (GranPaSmurf)